The feasibility of synthetic MRI in breast cancer patients: comparison of T2 relaxation time with multiecho spin echo T2 mapping method

Abstract

OBJECTIVE: To compare the T2 relaxation times acquired with synthetic MRI to those of multi-echo spin-echo sequences and to evaluate the usefulness of synthetic MRI in the clinical setting. METHODS: From January 2017 to May 2017, we included 51 patients with newly diagnosed breast cancer, who underwent additional synthetic MRI and multiecho spin echo (MESE) T2 mapping sequences. Synthetic MRI technique uses a multiecho and multidelay acquisition method for the simultaneous quantification of physical properties such as T1 and T2 relaxation times and proton density image map. A radiologist with 9 years of experience in breast imaging drew region of interests manually along the tumor margins on two consecutive axial sections including the center of tumor mass and in the fat tissue of contralateral breast on both synthetic T2 map and MESE T2 map images. RESULTS: The mean T2 relaxation time of the cancer was 84.75 ms (+/- 15.54) by synthetic MRI and 90.35 ms (+/- 19.22) by MESE T2 mapping. The mean T2 relaxation time of the fat was 129.22 ms (+/- 9.53) and 102.11 ms (+/- 13.9), respectively. Bland-Altman analysis showed mean difference of 8.4 ms for the breast cancer and a larger mean difference of 27.8 ms for the fat tissue. Spearman's correlation test showed that there was significant positive correlation between synthetic MRI and MESE sequences for the cancer (r = 0.713, p < 0.001) and for the fat (r = 0.551, p < 0.001). The positive estrogen receptor and low histologic grade were associated with little differences between two methods (p = 0.02 and = 0.043, respectively). CONCLUSION: T2 relaxation times of breast cancer acquired with synthetic MRI showed positive correlation with those of MESE T2 mapping. Synthetic MRI could be useful for the evaluation of tissue characteristics by simultaneous acquisition of several quantitative physical properties. ADVANCES IN KNOWLEDGE: Synthetic MRI is useful for the evaluation of T2 relaxation times of the breast cancers.